Revolutionary New Miracle Drug for Dry Eye?

Have you seen the TV ads with Jennifer Aniston describing her dry, itchy eyes and telling you to see an eye doctor about your Dry Eye symptoms?

It’s an interesting twist on the typical “ask your doctor about this new drug” ad. Because this ad never even mentions the drug.

Instead the campaign aims to raise awareness of Dry Eye by telling us to love our eyes, see our doctors, and talk to them about our symptoms.

Is Xiidra the revolutionary new miracle drug for Dry Eye?
Is Xiidra the revolutionary new miracle drug for Dry Eye?

We couldn’t agree more.

It’s incredibly important, if you’re suffering with Dry Eye symptoms, to see your doctor, because it’s literally impossible to diagnose your own specific Dry Eye condition. For one, you can’t see everything that’s going on unless you’re looking through a slit lamp. And you can’t always tell what’s going on just by what you feel. So for an accurate and comprehensive diagnosis, you need to see a really good eye doctor.

Visit the website that Jennifer Aniston talks about and you’ll learn that the campaign is sponsored by Shire, maker of Xiidra™ (lifitegrast ophthalmic solution 5%). Shire announced on August 29, 2016 that the drug cleared FDA approval and would be available by prescription in the US.

Revolutionary new miracle drug for Dry Eye?

And what exactly is Xiidra? Is it the revolutionary new miracle drug for Dry Eye that so many of us hope for?

Xiidra is a non-steroidal, anti-inflammatory “prescription eye drop used to treat the signs and symptoms of dry eye disease.”

According to Shire, “the most common side effects of Xiidra include eye irritation, discomfort or blurred vision when the drops are applied to the eyes, and an unusual taste sensation (dysgeusia).” Side effects were reported at least 5 – 25% of the time.

Although Xiidra is not the same product as Restasis, we noticed some similarities, namely:

  • They’re not sure how or why it works: “the exact mechanism of action of lifitegrast in dry eye disease is not known.”
  • You may have to use it for a while before you see any benefit.
  • It may cost a lot, depending on your insurance.

The product information sheet describes the clinical trial like this:

Enrollment criteria included, minimal signs (i.e., Corneal Fluorescein Staining (CFS) and non anesthetized Schirmer Tear Test (STT)) and symptoms (i.e., Eye Dryness Score (EDS) and Ocular Discomfort Score (ODS)) severity scores at baseline.

Note that “minimal signs” was an enrollment criteria, so there’s no indication from the study how the drops will work on someone with moderate or severe symptoms. And only non-anesthetized Schirmer tests were used. This test is usually used to screen for aqueous deficiency associated with Sjogren’s Syndrome (no tear production despite irritation) versus Schirmer with anesthetic, which tests for non-Sjogren’s aqueous deficiency. It’s not clear to us why they went with no anesthetic.

There are no results from a long-term or multi-year study. And since the drug was just released, there’s no post-marketing information — results from a large and diverse patient population.

The Xiidra product information sheet includes charts that show how well patients responded to the drug in the clinical trial. It takes a bit of detective work to tease out the information in the charts. (We would have preferred more details in the numbers, e.g.: how many benefited and how much, rather than one  single number adding them all up). In any case, here’s what we found:

  • Eye dryness scores usually improved a little more with Xiidra than with the placebo.
  • Corneal staining scores usually improved a little more with Xiidra than with the placebo.

Only a little better than the placebo. Oh well. At least for some maybe there will be some improvement in symptoms.

Bottom line – Xiidra may help some people with mild symptoms somewhat, with a decent chance of having some side effect. But it’s probably not the revolutionary new miracle drug for Dry Eye that patients hope for. That’s because most of us are still facing a multi-factorial, chronic disease, that requires diligent and persistent care under the supervision of a qualified and experienced eye doctor.

So take Jennifer Aniston’s advice if you have Dry Eye symptoms. Love your eyes and see your eye doctor.

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